The lifetime prevalence of psychiatric diagnoses in an academic gender reassignment service

PURPOSE OF THE REVIEW : To review the literature regarding the prevalence of mental health concerns, including psychiatric diagnoses in the TGNC community. RECENT FINDINGS : Gender dysphoria is not the only mental health concern experienced by some members of TGNC people. Stigma and discrimination play a role in the development of mental health concerns. Even after reassignment surgery some members of the TGNC community is almost 5 times more likely to attempt suicide. Using a structured clinical psychiatric interview improves the likelihood of recognizing the presence of psychiatric diagnoses. Non-affirming attitudes and behavior seem to predispose to psychiatric symptoms in some members of the TGNC community and impacts on family and peer relationships. Psychiatric symptoms are often hidden for fear of further discrimination. SUMMARY : A significant proportion of the TGNC community present with mental health concerns. Clinicians should screen appropriately for these concerns. Gender affirming interventions generally have an efficacious effect.The Department of Psychiatry at the University of Pretoriahttp://journals.lww.com/co-psychiatry2018-11-01hj2017Psychiatr

Case study : a patient with severe delusions who self-mutilates

Although some overlapping features exist between self-injury and intention to die, there is growing recognition that non-suicidal self-injury (NSSI), including major self-mutilation (MSM), and suicidal behaviour are distinct entities as evidenced by their significance in terms of aetiology, psychiatric impairment, psychological function, method of self-harm and course or outcome between the two phenomena.1 We present a case of self-harm in a mental healthcare user diagnosed with schizophrenia to highlight the distinction made above.http://www.sajpsychiatry.orgam2021Psychiatr

How can a 6-week training course shape mental healthcare professionals’ understanding of mindfulness? Experiences at Weskoppies Psychiatric Hospital

BACKGROUND: Mindfulness-based practice has gained increasing attention in the mental health community over the last four decades, and many studies have explored the evidence of its various benefits among healthcare users and providers alike. However, there remains limited research regarding the understanding of mindfulness among mental healthcare professionals. This poses the question: how much do mental healthcare professionals really know about mindfulness, and can self-practice increase the understanding of these providers? AIM: This descriptive or exploratory case study aimed to explore the understanding of mindfulness amongst 15 mental healthcare professionals. SETTING: The study took place at Weskoppies Psychiatric Hospital. METHOD: The study was conducted following a 6-week training course in which the participants were taught, and carried out mindfulness-based practices and techniques. The study also explored the following: (1) the healthcare workers’ experiences, benefits and challenges regarding the consistent practice of mindfulness and (2) their confidence when explaining the concept of mindfulness, and the practices learned, to other colleagues and patients. Data were collected in the form of semi-structured interviews with the participants, 4–6 weeks after completion of the training course. RESULTS: Three main themes were identified: (1) understanding of mindfulness expanded with practice; (2) unexpected experiences during the mindfulness course; and (3) experience caused partial gains in confidence and skills. Overall, 15 subthemes were derived from the data collected. CONCLUSION: Self-practice of mindfulness can increase one’s understanding of the concept and the confidence to teach informal techniques. More research is needed to determine how the design and duration of such training could impact this understanding and confidence.Research Committee of the University of Pretoria for the payment of the transcription services of Lynton Lurie.http://www.sajpsychiatry.orgPsychiatr

Erratum: Can overzealous reliance on evidence-based medicine overshadow good clinical judgement?

No abstract available

Can overzealous reliance on evidence-based medicine overshadow good clinical judgement?

In the past, the doctor’s knowledge, clinical skills and judgement were the ‘main impetus for treatment decisions, therapy assessment and medical progress’, with the ‘emphasis being on protecting and restoring human well-being’. While the advent of evidence-based medicine (EBM) and the increased use of innovative technology have undoubtedly enhanced the practice of medicine and dentistry, overzealous reliance and application of these carries a risk of overshadowing the human aspects of clinical judgement and decision making. This paper uses a dental example to illustrate and caution practitioners against losing site of the patient in their quest to treat the condition. It is important for any practitioner who engages in radiology beyond conventional 2D imaging being liable to examine it in its entirety and to report on findings from the entire field of view. They may need theoretical and practical training to do this, as failure to detect and manage any pathology is considered negligence and is grounds for litigation. Alternatively, they can refer the patient to a trained radiologist if they would prefer an expert opinion. The area of dental radiography will be used for the following ethical and legal debate; however, the principles questioned could be applied to all specialist referrals. The ethical question relates to the issue of how to manage a patient where the clinicians based their treatment on the diagnosis and report given to them by an expert in some other related specialist medical field, but where the report was erroneous, resulting in an unforeseen adverse outcome. What makes the case more complex was the contradiction between the clinical judgement and the radiological findings, which only became evident at the time of surgery

PACE Solver Description: GraPA-JAVA

We present an exact solver for the DFVS, submitted for the exact track of the Parameterized Algorithms and Computational Experiments challenge (PACE) in 2022. The solver heavily relies on data reduction (known from the literature and new reduction rules). The instances are then further processed by integer linear programming approaches. We implemented the algorithm in the scope of a student project at the University of Bremen

Factors associated with long hospitalisation for psychotic disorder patients in an acute ward: Tertiary care hospital

Background: The average length of stay is often used to indicate health system efficiency; shorter stays are associated with reduced costs. In South Africa, mental healthcare expenditure is spent on inpatient care. Aim: To identify factors associated with a long stay in an acute psychiatric unit. Setting: A tertiary hospital. Methods: A case-control study review of inpatients diagnosed with psychotic symptoms was used. Sample was divided into two groups, length of stay (LOS) (LOS greater than 21 days, LOS less than 14 days). Total of 82 patients were divided into short stay group (SSG, n = 23) and long stay group (LSG) (n = 59). A comparison of demographic, clinical and system variables was conducted. Results: In demographics, LSG had fewer men compared to SSG (78.3%) and differed statistically from LSG with p = 0.05. Long stay groups were older in comparison to SSG with a p = 0.02. Illicit substance use in LSG was 44.1% and statistically less than SSG (73.91%; p = 0.02). A high proportion of LSG had medical or surgical and psychiatric comorbidities (67.8%) compared to SSG (43.5%) (p = 0.04). A total of 95% patients in SSG had family support. Conclusion: Longer stay was found to be associated with older females with primary psychotic disorders. Comorbidities with less availability of family support were associated with younger males presenting with psychotic symptoms that may be related to illicit substances that respond to rapid stabilisation. Contribution: Active surveillance of medical comorbidities amongst older female patients is necessary for early liaison services to reduce their length of stay

Mental health symptoms among homeless shelter residents during COVID-19 lockdown in Tshwane, South Africa

Background: In order to contain the spread of COVID-19 in South Africa during the national state of emergency, the Gauteng Department of Social Development established temporary shelters and activated existing facilities to provide basic needs to street-homeless people in Tshwane, which facilitated primary health care service-delivery to this community. Aim: This study aimed to determine and analyse the prevalence of mental health symptoms and demographic characteristics among street-homeless people living in Tshwane’s shelters during lockdown. Setting: Homeless shelters set up in Tshwane during level 5 of the COVID-19 lockdown in South Africa. Methods: A cross-sectional, analytical study was conducted using a Diagnostic and Statistical Manual of Mental Disorders (DSM-5)-based questionnaire that looked at 13 mental health symptom domains. Results: Presence of moderate-to-severe symptoms were reported among the 295 participants as follows: substance use 202 (68%), anxiety 156 (53%), personality functioning 132 (44%), depression 85 (29%), sleep problems 77 (26%), somatic symptoms 69 (23%), anger 62 (21%), repetitive thoughts and behaviours 60 (20%), dissociation 55 (19%), mania 54 (18%), suicidal ideation 36 (12%), memory 33 (11%) and psychosis 23 (8%). Conclusion: A high burden of mental health symptoms was identified. Community-oriented and person-centred health services with clear care-coordination pathways are required to understand and overcome the barriers street-homeless people face in accessing health and social services. Contribution: This study determined the prevalence of mental health symptoms within the street-based population in Tshwane, which has not previously been studied

Mental health literacy among primary healthcare workers in South Africa and Zambia

Background In developing countries, mental health literacy (MHL) still needs to be improved due to the high prevalence of mental disorders. It is widely recognized that MHL can improve health outcomes for both individuals and populations. Healthcare professionals' development in MHL is crucial to the prevention of mental disorders. The aim of this study was to assess MHL of primary healthcare (PHC) workers in South Africa (SA) and Zambia and determinants thereof. Limited evidence is available on the levels of MHL among PHC workers in the sub-Saharan Africa region, which faces a large burden of mental disorders. Methods The study population for this cross-sectional survey comprised PHC workers (n = 250) in five provinces of SA and Zambia. MHL was measured with the Mental Health Literacy Scale (MHLS). We conducted a multivariate analysis to explore determinants of MHL. Results Results showed moderate MHL among PHC professionals, but with a wide range from low to high MHL. Knowledge-related items had a greater dispersion than other attributes of MHL. PHC workers with more education showed a greater ability to recognize mental health-related disorders. Those who had experience in the use of mental health-related assessment scales or screening tools reported a higher total MHL. The results confirmed strong internal consistency for the MHLS. Conclusion The results highlighted varying mental health perceptions and knowledge in PHC. Implementation of specifically developed formal training programs and interventions to improve MHL in PHC workers to strengthen their competence may help bridge the treatment gap.</p

Mental health literacy among primary healthcare workers in South Africa and Zambia

BACKGROUND : In developing countries, mental health literacy (MHL) still needs to be improved due to the high prevalence of mental disorders. It is widely recognized that MHL can improve health outcomes for both individuals and populations. Healthcare professionals’ development in MHL is crucial to the prevention of mental disorders. The aim of this study was to assess MHL of primary healthcare (PHC) workers in South Africa (SA) and Zambia and determinants thereof. Limited evidence is available on the levels of MHL among PHC workers in the sub-Saharan Africa region, which faces a large burden of mental disorders. METHODS : The study population for this cross-sectional survey comprised PHC workers (n = 250) in five provinces of SA and Zambia. MHL was measured with the Mental Health Literacy Scale (MHLS). We conducted a multivariate analysis to explore determinants of MHL. RESULTS : Results showed moderate MHL among PHC professionals, but with a wide range from low to high MHL. Knowledge-related items had a greater dispersion than other attributes of MHL. PHC workers with more education showed a greater ability to recognize mental health-related disorders. Those who had experience in the use of mental health-related assessment scales or screening tools reported a higher total MHL. The results confirmed strong internal consistency for the MHLS. CONCLUSION : The results highlighted varying mental health perceptions and knowledge in PHC. Implementation of specifically developed formal training programs and interventions to improve MHL in PHC workers to strengthen their competence may help bridge the treatment gap.Erasmus+ Capacity Building and European Commission.https://wileyonlinelibrary.com/journal/brb3am2023Psychiatr